Top Doctors: Hudson Valley’s Best-Rated Doctors in 2012

Solid credentials, proven skill, and a compassionate bedside manner — these qualities are the hallmarks of a top-flight physician. Here are 145 local doctors in 38 specialties who — according to their peers — make the grade

By Dale McKnight

(page 6 of 7)

Dr. Richard P. MacDermott

Gastroenterology, Albany

Dr. Richard P. MacDermott, who specializes in treating Crohn’s disease and ulcerative colitis, is enthusiastic about the latest treatments for these often-painful digestive conditions. “A lot of advances are going on in the field,” says MacDermott, director of the Inflammatory Bowel Diseases Center at Albany Medical Center.

Crohn’s disease triggers inflammation in various areas of the digestive tract lining and can involve affected tissue; it sometimes causes abdominal pain, severe diarrhea, even malnutrition. Ulcerative colitis can be equally debilitating; it usually occurs only in certain parts of the colon and has some similar symptoms. Both conditions (among others) fall under the umbrella term of inflammatory bowel disease, or IBD.

“I’ve always wanted to be in medicine, since I was young. And taking care of patients with these diseases, seeing how devastating they can be, is what got me interested in the field,” says MacDermott, who is also a professor of medicine at Albany Medical College. MacDermott earned his medical degree at Ohio State University and did residencies at Brigham and Women’s Hospital in Boston; with fellowships at Boston University and the Dana-Farber Cancer Institute. In January 2012, he was honored with the Lifetime Achievement Award from the Crohn’s and Colitis Foundation of America for his many contributions to the field, including research, teaching, and publishing. He and his family live in Latham.

“People with severe symptoms of Crohn’s and ulcerative colitis often fear leaving the house because of the symptoms. So it’s encouraging that there has been tremendous progress in the past 20 years — both in finding out what causes it, and in new medications.”

The latest breakthroughs include use of new biologics like Remicade, Cimzia, and Humira, he says. (Biologics are derived from living cells — similar to the way some vaccines are made — and are aimed at the immune system.) “Usually given by intravenous infusion or self-injection for these diseases, they’re very helpful for some patients.”

Surgery is also a key part of many treatment plans for Crohn’s, MacDermott says. “This often requires removal of part of the intestine. If you have severe disease, and there’s a complication like a stricture — a narrowing ­— or a perforation or abscess in the intestine, surgery can likely get rid of that. Then you can more effectively use a biologic afterward.”

Current treatments are now directed at specific parts of the immune system, he says. “That’s why many of these biologic agents are also used in rheumatoid arthritis, psoriasis, and other chronic inflammatory diseases — the immune system is functioning abnormally and causing damage to the joints or the skin.”

Both Crohn’s disease and ulcerative colitis are most often diagnosed during the teen or young adult years, says MacDermott. “But now we’re seeing more cases in children under age 10 — even by age five,” he says. “In general, Crohn’s disease and colitis are rapidly increasing, in terms of the number of patients at all ages around the world.”

Their exact cause is still unknown. “Genetics and the immune system both play a role,” says MacDermott. “It’s thought that diet is sometimes also a factor regarding the symptoms.”

Studies investigating the causes of Crohn’s and colitis have expanded over the past 10 to 15 years, MacDermott says. “The research is exciting. For instance, by sequencing the genes of patients (analyzing the genes’ “chemical alphabet”), about 150 areas on chromosomes involved with Crohn’s disease have been discovered, and about 50 areas involved with ulcerative colitis. It’s been determined that the genetic sequencing in Crohn’s or colitis patients is different from the sequence of people without the conditions,” he explains.

“Other ongoing studies in the U.S. and Europe are also now sequencing intestinal bacteria — there are maybe 15 or 20 thousand types of bacteria, with many subtypes. So I think that, when all this information is put together in the future, specific bacteria types will be shown to be involved with genetics and the immune system in initiating the disease. Then hopefully more targeted treatments can be developed for Crohn’s and colitis.”